BLS Basics

Assess the Scene

Check the scene for safety hazards BEFORE providing care, it is important to ensure if you and the patient(s) are in a safe location, free of imminent danger or hazards.

Determine

If it is safe to help

number of patients

if you will need additional assistance from EMS

what personal protective devices are readily available to you

Assess the Patient

Check the person for responsiveness

Tap on patient’s shoulder and shout “Are you okay?”

Look at the person’s chest and face

Determine if the patient is breathing normally

Agonal breathing is not normal breathing and needs care

Call 911 or direct a bystander call 911 and return

Caller should give dispatcher patient’s location, details of emergency situation including how many patients are injured and what treatment is occurring

Check for pulse (about 10 seconds)

Request AED machine, if available

If you are alone:

Adults:

FIRST call 911

Retrieve AED, if available

Perform CPR cycle until EMS takes over or you are too tired to continue

Children and Infants:

FIRST complete five cycles (about 2 minutes) of CPR

Call 911

Perform CPR cycle until EMS takes over or you are too tired to continue

Always provide care first for unresponsive patients of hypoxia arrest (i.e. lack of oxygen to the brain due to drowning, injury, drug overdose, stroke, etc…).When assessing the scene, be sure to assess approximate age and size of the patient. Suggested guidelines for administering CPR are as follows:

Adult CPR: should be administered to patients who have reached the onset of puberty and older.

Child CPR: should be administered to patients who have not reached the onset of puberty and are not considered infants (approximately 1 year to the onset of puberty).

Infant CPR: should be administered to patients who are younger than toddler aged (approximately birth to 1 year).

Chain of Survival

The Chain of Survival is a common way of describing the order in which rescuers should provide care for a patient of cardiac arrest. Early action can improve the chance of a patient’s survival.

Link Two: Early CPRRescuer immediately begins CPR cycle to continue minimal supply of blood to the patient’s heart and brain until defibrillator and EMS personnel take over.

Link Three: Early DefibrillationRescuer utilizes AED (automated external defibrillator) to administer a shock to the patient which may restore the heartbeat in some instances.

Link Four: Early Advanced CareEMS arrives and provides advanced cardiac life support care to patient of sudden cardiac arrest. In addition, EMS may provide IV fluids, medications, and use advanced airway devices.

Compressions - Airway - Breathing

C-A-B (Compressions-Airway-Breathing) Order

Begin Compressions

Open Airway with head tilt–chin lift method

Check Breathing AT THE SAME TIME

Head Tilt-Chin Lift Method

Place one hand on the forehead to tilt the patient’s head back. AT THE SAME TIME place the other hand under the patient’s chin, lift the chin to open the airway and displace the tongue. Look into the patient’s mouth for an obstruction. If you see an obstruction, remove it immediately.

Rescue Breaths

Keep airway open with head tilt-chin lift method. Administer one rescue breath (1 second). Observe chest for rise and fall. If breath does not go in, re-tilt head and administer second rescue breath (1 second). Observe chest for rise and fall AT THE SAME TIME as administering rescue breaths.

Use one of the following methods to administer rescue breaths:

Mouth-to-barrier

Mouth-to-nose

Mouth-to-stoma

Chest compressions, which keep oxygen flowing to the brain, is the single most important factor in life saving procedures. Chest compressions should be administered immediately following rescue breaths that do or do not appear to go into lungs.

Chest Compressions

Chest compressions should be swift and consistent, at a rate of 100-120 per minute. Place the heel of the dominant hand at the correct location on the adult or child patient’s chest. Use two fingers in the correct location of the infant’s chest.